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This is VAERS ID 284510

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

284510
VAERS Form:
Age:24.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-16
Onset:2007-04-16
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Injection site pain, Wrong technique in drug usage process

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a physician assistant concerning a 24 year old female who on 16-APR-2007 was vaccinated IM with 0.5 ml of the second dose of Gardasil (Lot #657617/0384U). On 16-APR-2007 the patient received the vaccine but the needle hi"t the bone in her upper arm an she has has soreness and pain in the site since then. The patient did not have any adverse symptoms after the first dose. Medical attention was sought. Additional information has been requested.


Changed on 12/8/2009

284510 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-16
Onset:2007-04-16
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Injection site pain, Wrong technique in drug usage process

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0705USA05428

Write-up:Information has been received from a physician assistant concerning a 24 year old female who on 16-APR-2007 was vaccinated IM with 0.5 ml of the second dose of Gardasil (Lot #657617/0384U). On 16-APR-2007 the patient received the vaccine but the needle hi"t hit the bone in her upper arm an she has has soreness and pain in the site since then. The patient did not have any adverse symptoms after the first dose. Medical attention was sought. Additional information has been requested.


Changed on 9/14/2017

284510 Before After
VAERS Form:(blank) 1
Age:24.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-16
Onset:2007-04-16
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 2 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Injection site pain, Wrong technique in drug usage process

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA05428

Write-up:Information has been received from a physician assistant concerning a 24 year old female who on 16-APR-2007 was vaccinated IM with 0.5 ml of the second dose of Gardasil (Lot #657617/0384U). On 16-APR-2007 the patient received the vaccine but the needle hit the bone in her upper arm an she has has soreness and pain in the site since then. The patient did not have any adverse symptoms after the first dose. Medical attention was sought. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=284510&WAYBACKHISTORY=ON


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